April 2021 | www.hepatitis.va.gov Non-Alcoholic Fatty Liver Disease Information for Patients

What is Non-Alcoholic Fatty Liver Disease? Losing more than 10% of your body weight can improve liver inflammation and scarring. Make a weight loss plan Non-alcoholic fatty liver disease or NAFLD is when fat is with your provider— and exercise to keep weight off. increased in the liver and there is not a clear cause such as excessive alcohol use. The fat deposits can cause liver damage. Exercise

NAFLD is divided into two types: simple fatty liver and non- Start small, with a 5-10 minute brisk walk for example, alcoholic steatohepatitis (NASH). Most people with NAFLD and gradually build up. Aim for 30 minutes of moderate have simple fatty liver, however 25-30% have NASH. With intensity exercise on most days of the week (150 minutes/ NASH, there is inflammation and scarring of the liver. A small week). The MOVE! Program is a free VA program to help number of people will develop significant scarring in their lose weight and keep it off. liver, called cirrhosis. Avoid Alcohol People with NAFLD often have one or more features of Minimize alcohol as much as possible. If you do drink, do metabolic syndrome: obesity, high blood pressure, low HDL not drink more than 1-2 drinks a day. Patients with cirrhosis cholesterol, insulin resistance or diabetes. of the liver should not drink alcohol at all.

NAFLD increases the risk for diabetes, cardiovascular disease, Treat high blood sugar and high cholesterol and kidney disease. Ask your provider if you have high blood sugar or high Most people feel fine and have no symptoms. Currently, there cholesterol. Certain medications can help lower blood are no FDA-approved medications to treat NAFLD. However, sugar levels and cholesterol. several medicines are being studied in clinical trials. What if I have NAFLD and another How will I know if I have NAFLD? liver disease? Talk to your health provider about screening for NAFLD if People can have fatty liver and other liver diseases— such you have type two diabetes. Your provider may perform as hepatitis C. People who drink alcohol over many years radiology tests (such as ultrasound). A non-invasive test called can also develop alcoholic liver disease including cirrhosis. FibroScan® may be used to meassure the amount of fat in Having two liver diseases can cause more liver injury and your liver and to look for fibrosis (scarring) in your liver. Some scarring, so it’s even more important to lose weight and people may need a liver biopsy. exercise—to decrease liver fat and injury. And be sure What can I do if I have NAFLD? to talk to your provider about treatment for other liver diseases as well. Lose weight Weight loss is the best treatment. Comprehensive lifestyle Resources modification, which includes changes in diet and increase in NAFLD patient guide and video: https://www.hepatitis.va.gov/ exercise, has the greatest, longest lasting weight loss benefit. MOVE! Weight Management Program: www.move.va.gov The good news is that NAFLD can be reversed if you lose more than 4% of your body weight. For example: • 8 pounds or more (if you’re 200 pounds) • 12 pounds or more (if you’re 300 pounds)